Dog bite and rabies

 

We went to this ladies house

 

We recently had some visitors and we took them to visit some of our work. We went to visit a pastoralists livestock enclosure on the border of village land. It is very typical for these households to have multiple dogs serving as both sentinels and herding dogs for their livestock. I expect at least two dogs and there are usually around five at the average livestock enclosure. 

When we walked in the group was warned that one particular dog was known to be very defensive and has the tendency to bite. I unfortunately did not get this announcement and at one point I ended up inadvertently blocking him in when I leaned up against a fence and the back of a hut. I initially had my back turned to him but turned around just in time to see him open mouthed snarling, sprinting at me full speed. I immediately recognized my spatial error just in time for the dog to bite my calf as it sprinted by barking. I was shocked and looked down at my torn trousers and wound. 

The bite wasn't that bad but did puncture the skin in multiple spots. I immediately put hand sanitizer on it as there was no soap available. I was lucky in that one of the guests was an extremely experienced and capable veterinarian who checked out the dog and thought it was not exhibiting any symptoms of rabies. Everyone also discussed the warning about the dog, which is when I realized I should have been keeping an eye on him. The vet thought I should be OK but we had to get back to wash it out with soap as soon as possible. Apparently washing the wound with soap and water can be a surprisingly effective method of preventing the transmission of rabies. 

I was pretty confident that the dog was not rabid but naturally I had some doubts and paranoia. I had received only one rabies vaccine in 2011 and I was ignorant of the vaccine regimes and current advice. For some reason I was really underplaying the importance and effectiveness of the rabies vaccine, especially considering I live in a wild environment and frequently work with wildlife. 

So I decided to educate myself and let me tell you, based on what I learned, I have been living dangerously! First things first, once symptoms appear, it is virtually 100% fatal. That is absolutely striking. And guess what? The vaccine? It is virtually 100% effective. The risk reward ratio on this one is irrefutable. 

I checked the guidelines and the CDC actually updated their vaccine guidelines in June this year. It's encouraging that they are continuing to do research to find the best protocols. I did not think that I was exposed and thus I only needed one dose, another dose a week later, and then an optional booster 2-3 years after. That is it. If I was not vaccinated and exposed to rabies I would need a series of five shots within a month as well as needing an immediate injection of immunoglobulin at the wound site. Seeing is that I work in an area with endemic rabies (we've heard of dogs with rabies and people being infected) and working with wildlife, it is an easy call to get the injections.

Luckily this vaccine is readily available in Iringa town. We bought a vial for 28,000 TSH ($12) and then found a random health clinic to administer it (costing an additional do $1.00). It does require a cold chain so we'll probably come to town for the second dose. 

I really learned a lot about the rabies vaccine and as mentioned, I think I was a little to casual about it before. I will now recommend it to people in the field or at risk as it's a simple, relatively cheap, and effective prevention measure.